Joint replacement surgery is where a surgeon removes all or parts of a worn out joint and replaces it with an artificial joint, which is usually made out of metal, ceramic, or plastic. This type of surgery is sometimes recommended if you’re in severe pain and you’ve tried other options – like medication, exercise, and pain management strategies (like drug-free FlexiSEQ) – without avail.
Arthritis is often the reason why someone may be offered joint replacement surgery – this will usually be a result of osteoarthritis, but some people with rheumatoid arthritis may also benefit. This type of surgery may also be offered if you have a broken bone in your joint, or post-traumatic arthritis resulting from an injury or accident.
Joint replacement surgery is fairly common in the UK, with over 200,000 knee and hip replacements performed each year. Despite this, there are some unhelpful myths circulating around joint replacements. If you’re thinking about getting joint replacement surgery, or you’re already on the list, we want to make sure you understand the truth behind the myths so you can feel reassured and empowered.
1. Only People Over 60 Get Joint Replacements
False: While the average age for joint replacement surgery is around 65, this doesn’t mean no one under 60 gets this procedure. Your joints may have been impacted by a degenerative condition at a younger age, or perhaps your joints got damaged due to injury. Everyone is an individual, and their joint needs will be different.
“In general, joint replacement surgery should be the last treatment option in patients with debilitating wear and tear,” says Mitch McDowell, a Fellowship Trained Orthopedic Surgeon, President at M Bone and Joint. “We are more cautious to recommend knee replacement in young patients because these parts do wear down. The majority of young patients that require joint replacement are often due to different problems such as cancer, tumors, trauma, congenital abnormalities, or severe joint pain that limits daily activities that can necessitate joint replacement surgery in younger individuals. The decision is based on the patient’s overall health, pain level, and lifestyle needs rather than age alone.”
2. Rehabilitation Takes Months at a Rehabilitation Centre
False: While you can expect some pain as the area heals, many people stand and walk with assistance the day of the surgery and tend to go home fairly quickly, often within a week.
“With modern and minimally invasive techniques it’s very rare that a patient would require a lengthy stay in a rehabilitation center,” says Mitch McDowell. “Most patients start physical therapy within a few hours of surgery in the hospital or surgery center. My preference, and I believe is the same as most orthopedic surgeons, is for my patients to go home as soon as possible. This usually includes having a physical therapist come out to your house for the first three weeks, then transition to outpatient physical therapy. The duration and intensity of rehab depend on the individual and the specific joint replaced, but many patients are able to resume normal activities within weeks to a few months, with full recovery taking up to a year.”
3. Joint Replacements Only Last for 10 Years
False: While artificial joints do wear down over time, you can expect them to last at least 15 to 20 years. “Current data on implants indicate that on average, hip and knee replacements last about 20 years,” says Mitch McDowell. “We suspect that with our modern implants especially the modern bearing services (polyethylene liners) that are current models will actually last longer than most patients. Now, these are bearing surfaces just like tires in the car and the wear and tear is variable and depends on factors such as the patient’s activity level, weight, and adherence to post-operative care. Regular follow-ups are important as is antibiotic prophylaxis prior to invasive procedures.”
4. Joint Replacement Surgery is Always Elective
False: Joint replacement surgery may feel necessary if you are in long term pain and other options don’t help to the extent you’d need them to. You deserve to enjoy your life, and if your joint pain is stopping you from doing that, then joint replacement surgery may make a huge difference to your quality of life.
“This is something brought up very frequently and I believe the problem is the term elective,” says Mitch McDowell. “Joint replacement procedures are not “elective” like a cosmetic breast procedure or facelift and as such. For most patients, surgery is indicated when conservative treatments like medication, physical therapy, or lifestyle modifications fail to relieve symptoms and the activities of daily living are compromised. It is at that point in which “elective” surgery becomes a necessary intervention to improve quality of life. Nonetheless, there are some cases in which they may be medically necessary due to fracture, impending fracture or cancer.”
5. Joint Replacement Surgery Can Cure All Types of Arthritis
False: Joint replacement surgery can certainly help you regain mobility and decrease pain around joints that have been impacted by arthritis, but it won’t cure the root cause of the arthritis itself (there is currently no cure for arthritis) and it may not be appropriate for all types of arthritis.
“Arthritis means “inflammation of the joint” and there are hundreds of different types of arthritis,” says Mitch McDowell. “Joint replacement surgery primarily addresses osteoarthritis (wear and tear) by replacing the damaged bearing surface (cartilage, meniscus) with a prosthetic one. I like to explain to patients that this is a mechanical surgery and we can’t fix biology problems with mechanics. An example would be for a patient with gout, the patient has a condition in which their body is depositing crystals into your joint after eating too many sausages (red wine, etc), I can clean out the crystals and remove the damage they have done, but I can’t stop your body from depositing crystals in the future when you start eating sausages. The same is true for other types of arthritis such as rheumatoid arthritis, which is an autoimmune condition. We can fix the wear and tear that rheumatoid arthritis has sped up, but we can’t change the biology of your immune system with surgery.”
6. You Will Need a Card Saying You Have an Implant to Fly
FALSE: Worried about an awkward encounter at the security checks in an airport? It makes sense why this might be a concern, but joint replacements are pretty common these days and airport security should be aware of it being a possibility. “Metal detectors at airports may be triggered by the metallic components of joint implants,” says Mitch McDowell. “Having a card or documentation may make security checks easier, but most security personnel are trained to handle such situations routinely and don’t look for these documents routinely.”
7. Joint Replacement Surgery is Extremely Risky
FALSE: It’s natural to be concerned about the risks of any surgery, especially a major one, but joint replacement surgery is generally safe and effective. “While joint replacement surgery is still a major surgery, advances in surgical techniques, regional anesthesia, newer medications to stem blood loss, early mobilization and post-operative care have greatly reduced the risks associated with these procedures, says Mitch McDowell. “In fact, many of these surgeries are now done as an “outpatient” meaning that the patient is able to go home the same day. Complications are rare and typically manageable when they do occur.”
As with any surgery, there is a small risk of infection, blood clots, nerve injury, and complications due to anaesthetic. While rare, it is still important to look out for warning signs and seek medical care immediately if you start experiencing chest pain, shortness of breath, a high fever, oozing or pus around the area, and/or redness, tenderness, or swelling which seems to be getting worse.
Have we missed any common myths about joint replacement surgery? Have you had joint replacement surgery and if so how did it go for you? Let us know on Facebook!
